Smoking in the LGBT community

Missouri has one of the highest smoking rates in the nation -- at 21 percent, it's double the rate in states like Utah and California. But some segments of the population smoke even more. In this week's Health & Wealth update, I talk with MU researchers who have found that the smoking rate among lesbian, gay, bisexual and transgender Missourians is much higher than in the population at large.

Researchers have known for a while that smoking rates are higher among the LGBT community. But there aren't a lot of hard numbers. The problem is that national and state health surveys don't include questions about sexual orientation. So we must rely mostly on smaller studies. One review of research found smoking rates among the LGBT community to be 50 percent to 250 percent higher.

Kevin Everett and Jane McElroy are associate professors at the MU school of medicine. In 2008, they started going to Pride festivals around Missouri, and asking people about their smoking habits. So far they've surveyed around 10,000 people, and found the LGBT smoking rate to be much higher than the already high Missouri rate.

"In some elements of that community, almost double to triple the general population rate," says Everett. "We find in LGBT Missourians, that range is between 35 and 40 percent."

Why the higher rate? Everett says nobody knows for sure, but one explanation is that the tobacco industry has targeted the gay community. "They developed specific campaigns for that community and push the product heavily," says Everett. Another possible factor is the gay bar culture: "Their primary areas of socialization at some level included smoking."

McElroy adds another possible explanation: "One aspect of being part of the LGBT community is stress, there's just a tremendous amount of stress. By nature of who they are, there's lots of discrimination that goes on," she says. "For some folks, they feel that smoking is a stress reducing tool. It's sort of that self-medication."

But another explanation, says Everett, is that a lack of data on LGBT smoking has lead to a lack of targeted education and intervention. "Health care providers and systems have not done a good job in terms of recognizing this as a group who has high smoking rates, and so research and intervention and treatment has not been targeted to that area."

On that front there is good news. Starting in 2013, national health surveys conducted by the federal government will include sexual orientation. That means, for the first time, these national statistics will be tracking the health of the LGBT community.

Here in Missouri, Everett and McElroy will continue their Pride festival surveys, as the federal data won't provide reliable numbers at the state level. But they will also start focusing on ways to target education and intervention toward the LGBT community. In December they received a $315,700 grant from the Missouri Foundation for Health for pilot programs to reduce tobacco use in the LGBT community.